The healthcare system can be a jarring place, full of confusion and doubt – the insurance, the billing, the helplessness we often feel when we’re injured or ill and have to leave our bodily repair to another person. I hate watching doctors fill out forms hidden behind clipboards, or that antsy, purgatory-esque feeling I get while sitting in the waiting room – even the questions about my health, my habits, my diet, my penchant for a daily after-work beer leave me unnerved.

But in all my worries about a visit to the doctor, I have never had the fear that the person examining me might be choking back their disgust at having to look at me in their waiting room. And yet, that is exactly the protagonist we encounter in Herman Koch’s newest novel, Summer House with Swimming Pool.

Dr. Marc Schlosser is a successful general practitioner who has developed a reputation as a caring and thorough doctor, one who allows his patients extra time and attention in his office, and won’t shame them about their overindulgence in wine or cigarettes. But perhaps his greatest success is hiding the total disgust he feels for the patients who walk through his door every day:

“I do my best to act interested. Meanwhile, I doodle on a scrap of paper. I ask them to get up, to follow me to the examination room. Occasionally I’ll ask someone to undress behind the screen, but most of the time I don’t. Human bodies are horrible enough as it is, even with their clothes on. I don’t want to see them, those parts where the sun never shines. Not the folds of fat in which it is always too warm and the bacteria have free rein, not the fungal growths and infections between the toes, beneath the nails, not the fingers that scratch here, the fingers that rub there until it starts to bleed…Here, Doctor, here’s where it itches really badly … No, I don’t want to see. I pretend to look, but I’m thinking about something else.”

It’s a humorous take, but Schlosser is a chilling protagonist, a man respected professionally and admired for his beautiful family, yet filled with a clear loathing for humanity. There’s something truly disturbing about your neighborhood doctor dreaming of your demise as he checks you for new moles. He’s one of the few protagonists I have ever encountered whom I felt I couldn’t picture physically, I couldn’t imagine how he looked or dressed – despite some fleeting references to his good looks – but that isn’t due to a lack of writing or character development on Koch’s part; it’s simply that Schlosser had hidden so many parts of his life and person from even those closest to him, that he’s become something of an enigma. His lifestyle seems unsustainable – how has he continued to deal with the patients he despises – so it’s hardly a surprise that the opening of the book reveals that all is not exactly well. Dr. Schlosser is being investigated for the death of one of his patients, the famous actor Ralph Meier.

Meier befriended the doctor, inviting him to parties and eventually to his family’s summer home. Schlosser – however – is more interested in Meier’s wife, Judith, and begins a scheme to bring his two daughters and wife along for a seemingly innocent vacation weekend with Meier’s family, and a visiting director and his model girlfriend. Like many of his previous books, the male characters that populate Summer House are all reprehensible – Schlosser is obsessed with Meier’s wandering eye and inappropriate advances on his daughters and the director’s relationship with a very young girl is cringe-worthy. But the real horror begins when a tragedy befalls one of the house guests and Schlosser’s attempts to keep his feelings toward Judith lead to the worst betrayals of all. Yet all of this plays out below the surface of seemingly calm waters – afternoons lounging by the pool and dinners of freshly caught seafood. And Koch keeps you on edge, saving his reveal for the very end.

Koch’s mastery – and the thing that makes this novel such a great read – lies in his ability to approach deceit and cruelty and horror with an even tone. Schlosser himself is the epitome of a professional family man, and yet his inner life is so dark, it’s a wonder he can move through the daily machinations of life. Of course he does just that and so do all of the other characters who fall under suspicion. They drink their coffee, they make small talk, they laugh. Koch has a way of normalizing the vilest of acts and it’s that cool approach that both chilled and engrossed me. It’s always the things lurking underneath the mundane that are the scariest – even lighthearted adolescent love isn’t safe from Koch’s scheming plot.

Summer House is a certainly a great beach read – it’s gripping and quick, and smarter than your average summer novel – but it’s certainly no lighthearted affair. And it’s certain to make you even more squeamish the next time you find yourself in a doctor’s waiting room.

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Just waiting for the fist person to say we have to double down on stupid and propose single payer.

Yanotha Twangai

You’d rather we double down on stupid by turning our health care system over to the jungle rules of the amoral free market?

Sue de Nim

What’s stupid is not learning from the experiences of other countries, where they’re getting overall better health care outcomes at much lower cost with strategies like single payer (isolated horror stories notwithstanding).

JQP

how about the 234 millionth.
shouldn’t be too long now.

Kelli W

So, we finally make some progress on health care for all in MN – especially for those like myself that own a small business- one of the first states to do so- and because of some setbacks and negative criticism we are considering starting over? Why not spend the money we would use in starting over by actually fixing & fine tuning the current process just briefly put in place? Give it time to work itself out and work on fixing the problem areas.

J F Hanson

All four of the comments posted so far simply don’t address the issue–that the state government leadership, in all its glorious ineptitude, spent $100 million or so (and climbing) on a software “solution” that its politicians wanted.

The result has been a conservative’s dream of political decision, political influence, and sheer political incompetence, from the Dear Leader on the federal level on down to Chairman Dayton’s on the State Level. However, it is doubtful that a solution under Republican control would have been much different–but that observation is for another discussion.

Of course they should scrap it–and probably start over–and, do it as a long-term project to keep the elected politicians’ hands off it.

But that work should begin only after these same politicians fund a project to provide for effective management of such a project.

And, I should add, after they figure out how to get any taxpayer money out of stadiums.

Yanotha Twangai

And how do you propose to “keep the elected politicians’ hands off it”? Appoint a dictator? What unelected authority would you trust to lead such a “project”?

JQP

eliminate the political appointment of civil service positions.
once the elected officials only control is budget and coherent laws… they’ll settle down.

right now … they write ambiguous laws and then insert into and “they” know what to do winkity winkity winkity

J F Hanson

I’m convinced that a tightly-defined and trained in the skills needed civil service manager could do this if a firewall can be built to prevent political interference.

The press could–such as MPR, were it to cease being a politically-liberal cheering squad on this issue–well serve as the watchdog.

Gary F

I’m still wondering why the Minnesota media has finally reported this? They have kinda been accomplices to this disaster all along by not giving any of this the scrutiny that real unbiased journalists should be doing. Just think if they expended the effort that is currently happening in the Chris Christy scandal and asked tough questions and held people accountable? And you wonder why people call MPR and the Star Tribune biased?

Just think, in the next month or so, the MN legislature will convene and they will want to spend, spend, spend, that projected surplus and give us more of this crap.

Rich in Duluth

No, it’s complex software. Have the contractor fix it and withhold payments until it’s working correctly.

The people in this state and country don’t need health insurance; they need health care. Obviously, health insurance adds a layer of expensive complexity for which we get nothing. I’ll say it, we need Medicare for everyone, where you go to the doctor and she sends the bill to Medicare…no insurance company taking money from the system for nothing in return.

I’m now on Medicare and it works great…and the web site works great.

J F Hanson

I concur with what you say, but we cannot overlook the very real problems in Medicare–the fee scale should reflect honest reimbursement, not political chicanery, the fundamental design flaw of paying without consequence for every test has to be removed, and the level of fraud–and related incompetent oversight should be fixed.

But as it stands, I would feel guilty running only on Medicare without adjunct insurance.

And Obozo wants to double the rate next year–remember that.

Jim G

A very close relative is an IT project manager/ business analyst. What I have learned about IT projects from living with this close relative is that it is imperative to get the Requirements portion of the Project Management Process right before you start building any software application or website. It looks as if that basic project manager/ business analyst skills were not employed by whoever was in charge of building the MNsure website.

Yes, if we want to get this website working smoothly, go back to the Requirements needed for the functionality of the site. Start over, and do it correctly.

J F Hanson

Lock those in and then lock the politicians out. It will slow down the never-ending spin from those fools.